By Kevin Rector, krector@tribune.com
December 13, 2011 | 6:16 p.m.
The parents of a Woodstock teen who died 10 days after losing oxygen during a routine wisdom tooth surgery March 28 in Columbia are suing the anesthesiologist and the oral surgeon involved for medical malpractice, according to court records filed Nov. 30.
The civil suit, which also names three dental practices associated with the doctors, is the latest development in an unusual medical case that shocked the Marriotts Ridge High School community, where Jennifer "Jenny" Michelle Olenick was a smiley, 17-year-old junior involved in choir.
The suit claims that Dr. Krista Michelle Isaacs, the anesthesiologist, and Dr. Domenick Coletti, the oral surgeon, were negligent in their care of Olenick and failed to resuscitate her after her heart rate slowed to a "panic level" of 40 beats per minute and her body began losing oxygen.
The suit claims those failures led to Olenick not having a pulse when emergency responders arrived at Coletti's Columbia office, and that they directly allowed for the "massive and irreversible brain injury" that resulted in her death April 6.
The lawsuit, filed in Howard County Circuit Court, follows an investigation into Olenick's death by the state's Office of the Chief Medical Examiner, which found the central cause of death was hypoxia — a deprivation of oxygen — that occurred while Olenick was anesthetized during the procedure.
Olenick's mother, Cathy Garger, called her daughter's death "needless" and said she hopes to raise awareness of dental-related deaths nationwide.
"I am trying to make people aware that a routine visit to the dentist or an oral surgeon can turn out anything but routine," she said.
Anesthesia problems
According to Dr. David Fowler, the state's chief medical examiner, Olenick was first given a standard dose of anesthesia during the procedure that did not "get her deep enough so she was fully anesthetized."
More anesthesia was then administered by Isaacs, which was also standard procedure, Fowler said in an interview. At approximately 8:05 a.m., Olenick began to experience bradycardia, or a slowing of her heart rate, according to the lawsuit.
"A little while later, the oxygen saturation in her blood started dropping," Fowler said.
Shortly thereafter, according to the autopsy report, Olenick went into hypoxic arrest. Emergency responders were called and advanced cardiovascular life support protocol was initiated by Isaacs, according to an expert witness assessment attached to the lawsuit.
Once the emergency responders arrived, they were able to regain a pulse within four minutes, the lawsuit states.
Olenick was rushed first to Howard County General Hospital and then to Johns Hopkins Hospital for more specialized care, where she died April 6 after being in a coma, Garger said.
The autopsy found that Olenick suffered acute hypoxic-ischemic encephalopathy, or damage to the brain from a lack of oxygen, and severe brain edema, or swelling of the brain tissue.
According to Robert Stoelting, president of the Anesthesia Patient Safety Foundation, a patient's breathing and oxygenation should constantly be monitored during operations involving anesthesia through the use of medical equipment, namely a pulse oximeter, and "caregiver observation" of the patient's breathing and airway.
"This monitoring would recognize the development of hypoxia before it caused cardiac arrest," Stoelting wrote in an email. Stoelting would not comment on Olenick's case specifically.
The Howard County Police Department never opened a criminal investigation into Olenick's death, according to police spokeswoman Sherry Llewellyn.
The autoposy report did not speculate on why hypoxia occurred and determined the death was accidental.
The report said Olenick was otherwise a "healthy teenager with no significant medical history."
Not a 'freak' accident?
Olenick's death shocked local dental practitioners, some of whom expressed support and undiminished professional respect for Coletti, and scared some local students facing similar procedures.
At a memorial service for Olenick April 17, Garger called her daughter's death a "freak thing that happened," and told students at the event not to be afraid of anesthesia.
"I don't want anyone to ever be afraid to go under anesthesia, because like the doctors said, this was freak," Garger said at the time. But last week, Garger said her thoughts had changed and that she had decided to file the malpractice lawsuit after being "horrified" by the autopsy report and other medical records.
"Information was obtained from medical records that suggested this wasn't a freak accident after all," Garger said. "Upon reviewing that information, we decided to pursue legal measures." Garger would not elaborate.
Both of Olenick's parents and her estate are now plaintiffs in the medical malpractice suit, which was brought against Isaacs; Coletti; Central Maryland Oral and Maxillofacial Surgery PA and Baltimore Washington Oral and Maxillofacial Surgery Center LLC, both Columbia practices in which Coletti is a partner; and Safe Sedation LLC, which the Maryland Board of Physicians Web site lists as Isaacs' primary practice setting.
Coletti did not respond to multiple requests for comment through phone calls to his office and direct emails.
Isaacs, when reached by phone and asked her thoughts on the lawsuit, which names her as the lead plaintiff, said she had been "advised by counsel not to discuss this case" and declined to answer further questions, including whether she has an attorney.
A request for comment to Safe Sedation LLC, which has since been renamed Aisthesis, went unanswered.
The lawsuit, in a total of five counts, includes one claim that Isaacs and Coletti were negligent in their treatment of Olenick, in part by failing to adequately resuscitate her; one claim they failed to properly inform Olenick and her parents of the risks of the procedure and the dental techniques being used; one claim each from both parents that Isaacs and Coletti's negligence caused them to lose the "love, support, guidance, advice and comfort" they received from their daughter; and one claim that their negligence has caused Olenick's parents to incur "dental, surgical, medical, hospital, pharmacological, funeral, burial, and other losses and expenses."
None of the counts list explicit monetary damages, but all state that "the amount in controversy" exceeds $30,000.
Pushing for dental safety
The lawsuit isn't Garger's only effort to actively address her daughter's death. She has also been in touch with the Raven Maria Blanco Foundation, Inc., a group that advocates for dental safety nationwide. The group's Web site now names Jennifer Michelle Olenick in a list of 36 kids who the group says have died in dental-related incidents since 1974.
Garger hopes her daughter's story, and maybe the lawsuit, will help make a difference.
"Every year many people are dying dental-related deaths, and it is not until family make a statement that more stringent dental mandates will ever come about," she said.
Garger would not elaborate on her thoughts about her daughter's case or what she feels went wrong during her daughter's procedure.
Her attorney, Jonathan Schochor, senior managing partner of Schochor, Federico and Staton, P.A., did not respond to multiple requests for comment through phone calls to his firm and direct emails.
Schochor and Olenick's parents have requested a jury trial in the case. A date has not been set.